But will it have any affect in the states that currently have it?
Every state already 'has' Medicaid. The program is jointly funded by the federal government and the states, but the states essentially decide how to administer it. So different states can have different eligibility requirements and use different health insurance providers to actually provide the coverage.
ObamaCare was supposed to significantly expand who the states would be required to accept in order to get the federal funding, while also increasing the amount the federal government gives the states for the program. The Supreme Court though ruled that even if a state doesn't follow the new eligibility rules, they still get the original lower amount of federal funding. Because of this, some of the states will be 'participating' (accepting more people for Medicaid) and other will not. See
this map for which states are and which aren't.
ETA - The map is not completely up to date, but each of the states listed there as 'leaning' ended up going the way they leaned. Of the 'pursuing alternative model' states, Iowa and Arkansas are listed as expanding, while Indiana and Tennessee are not. This is all according to medicaid.gov.